(CMS-10545) Outcome and Assessment Information Set (OASIS) OASIS–C2/ICD–10

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10545 Medicare and Medicaid Programs OASIS Collection Requirement (Training)	Form and Instruction	Modified	Available
Form CMS-10545 Medicare and Medicaid OASIS Collection Requirements (Data Collection)	Form and Instruction	Modified	Available
CMS-10545 OASIS C2_public comments and responses_6.23.2016 final version.doc	Supplementary Document	Uploaded 2016-07-05	Available
CMS-10545.OASISC2 Supporting Statement Part A- 12-9-16 (final).docx	Supporting Statement A	Uploaded 2016-12-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
215973	Medicare and Medicaid Programs OASIS Collection Requirement (Training)	Form and Instruction	Modified
215972	Medicare and Medicaid OASIS Collection Requirements (Data Collection)	Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1279	ICR Reference No: 201607-0938-001
Status: Historical Active	Previous ICR Reference No: 201503-0938-011
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: (CMS-10545) Outcome and Assessment Information Set (OASIS) OASIS–C2/ICD–10
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/09/2016
	Date Received in OIRA: 07/07/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019	36 Months From Approved	05/31/2018
Responses	17,912,198	0	17,280,904
Time Burden (Hours)	15,812,511	0	15,320,253
Cost Burden (Dollars)	0	0	0

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Abstract: This request is for OMB PRA approval of a version upgrade of the Outcome and Assessment Information Set (OASIS-C1/ICD-10). The upgraded version of the OASIS item set is titled OASIS –C2.

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Authorizing Statute(s): PL: Pub.L. 105 - 33 4601(e) Name of Law: Balanced Budget Act of 1997
   US Code: 42 USC 1395x Name of Law: Definitions of Services, Institutions,etc: Home Health Agency
   PL: Pub.L. 109 - 171 5201(c)(2) Name of Law: Deficit Reduction Act of 2005: Home health - pay for reporting of quality information
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 18855	04/01/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 42711	06/30/2016
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Medicare and Medicaid OASIS Collection Requirements (Data Collection)	CMS-10545	OASIS-C2 ICD-10 Item Set
Medicare and Medicaid Programs OASIS Collection Requirement (Training)	CMS-10545	Oasis-C2/ICD-10 Item Set

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	17,912,198	17,280,904	0	631,294	0	0
Annual Time Burden (Hours)	15,812,511	15,320,253	0	492,258	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There has been a slight change in the burden estimate due to an increase in the number of active HHAs. The burden hours have increased from 15,320,253 to 15,812,511.

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Annual Cost to Federal Government: $1,500,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/07/2016

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